BREAST RECONSTRUCTION IN PREVIOUSLY IRRADIATED PATIENTS USING TISSUE EXPANDERS AND IMPLANTS - A POTENTIALLY UNFAVORABLE RESULT

There exists a paucity of definitive information on the suitability or implant reconstructions in previously Irradiated breast cancer patien ts. This controversial topic prompted a review of our prosthetic recon structions in this select group of patients. A retrospective study of patients treated between 1976 and 1993 with lumpectomy and radiation t herapy far early breast cancer revealed 67 patients with local recurre nces, Nine of these pa tients (10 breasts) underwent a two-stage prost hetic reconstruction following a salvage mastectomy. The average age w as 47.9 years. The mean dose of irradiation was 6,070 cGy, The average interval from radiation therapy to placement of a tissue expander was 4.6 years, In one patient (10%) the tissue expander extruded, The ave rage follow-up for 8 patients (9 breasts) who underwent exchange to a permanent, prosthesis was 5.1 years. In four reconstructions (40%) the re was an uneventful postoperative course. Two cases (20%) were diffic ult to expand and the final result lacked projection, One patient (10% ) developed an infection requiring removal of the permanent prosthesis , Two patients (20%) developed Baker class III or IV capsular contract ures. Overall, in our group of 10 implant reconstructions, 60% of the patients resulted in either a complication or an unfavorable result.